Which Profession Has the Highest Risk for AK and NMSC?



Mountain guides have the highest risk for nonmelanoma skin cancer (NMSC), including actinic keratosis, according to the findings of a recent study.

The cross-sectional study included a total of 563 participants, 348 were outdoor workers (38.8% were farmers, 35.3% were gardeners, and 25.9% were mountain guides) and 215 were indoor workers. Participants completed a paper-based questionnaire on UV exposure and sun protective behaviors, as well as received a skin exam from a dermatologist.   
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Actinic keratosis was diagnosed in 19.5% of gardeners, 27.4% of farmers, and 33.3% of mountain guides compared with 5.6% of indoor workers. Mountain guides had the highest risk for NMSC compared with farmers (odds ratio [OR] 2.6; 95% CI, 1.2-5.7). 

In addition, skin cancer screening attendance rates differed significantly between professions (27.6% of gardeners, 31.9% of farmers, and 57.8% of mountain guides vs 61.4% of indoor workers), as well as daily UVR exposure and use of sun protective behaviors, such as sunscreen, during working hours.

“Different outdoor professions have significantly different risks for NMSC and show different risk behavior,” the researchers concluded. “Tailoring prevention efforts to different professions based on their individual needs could be the key to lower the global burden of (occupational) NMSC.” 


Zink A, Tizek L, Schielein M, Böhner A, Biedermann T, Wildner M. Different outdoor professions have different risks - a cross-sectional study comparing non-melanoma skin cancer risk among farmers, gardeners and mountain guides. J Eur Acad Dermatol Venereol. 2018;32(10):1695-1701.